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Sleep Disorders

SCI and Sleep Paralysis

09/18/2007

Question:

I was curious if there could be a link between spinal cord injury and sleep paralysis?

Answer:

This is an interesting question. While spinal cord injury and sleep paralysis both have the symptom of paralysis, sleep associate paralysis is a temporary phenomenon that has a significantly different mechanism from spinal cord injury. In spinal cord injury, the nerves originating from the spinal cord are damaged and no longer functional, resulting in loss of muscle function.

This is contrasted to sleep paralysis, in which signals originating from the brainstem (the lower part of the brain in the skull) travel down through intact and functioning nerves in the spinal cord and lead to an inhibition (or blocking) of muscle activity at the nerve-muscle fiber level. Sleep paralysis is part of normal dream sleep (REM sleep) physiology and only becomes a problem when this phenomenon occurs during transitions from sleep to the awake state.

I was unable to find any data examining any type of an association between the 2 conditions. However, I will provide some information about sleep paralysis and hopefully this may help you out.

Sleep paralysis is extremely common with up to 15-40% of young adults experiencing this at least once in their lifetime and as many as 5-6% have this occur recurrently. Sleep paralysis is usually described as the inability to perform voluntary movements either at sleep onset or upon awakening. Individuals often report that they cannot speak or move the limbs, trunk or head. While breathing is actually not affected, the sensation of not being able to breath can accompany the paralysis and can be quite scary. Most individuals will recall the events. The episodes usually only last for seconds up to a few minutes and tend to resolve on their own. Occasionally, the episode will end if the person is touched or spoken to.

Episodes of sleep paralysis can be very anxiety producing. In addition to the sensation of not being able to breathe, hallucinations, whether hearing or seeing things that are not present, can accompany the event. Sleep paralysis can be brought on by lack of adequate sleep, keeping an irregular sleep schedule and being under excessive stress. While most of the time sleep paralysis is not associated with other medical conditions, it can be one of the signs of narcolepsy (individuals with this condition also experience uncontrollable

Other medical conditions that can appear with similar symptoms to sleep paralysis include compressed nerves, cataplexy (sudden loss of muscle control in emotionally charged situations such as laughing), seizures, and panic attacks. Most of these conditions can be separated from sleep paralysis by specific factors from the medical history.

If you are concerned about your symptoms or would like to exclude the other possibilities mentioned above, I recommend you discuss your problems with your primary care doctor. They can then decide if referral to a Sleep Specialist is needed for further evaluation.

If you would like further information about sleep disorders or sleep itself, I recommend the American Academy of Sleep Medicine website. In addition to information about sleep medicine, the website also contains a list of accredited Sleep Centers and may help you to locate one nearest you. Good Luck!

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University